Q– General Acute Medical Services Manchester VAMC
Notice Type: Sources Sought Notice
Posted Date:
Office Address:
Subject: Q-- General Acute Medical Services Manchester VAMC
Classification Code:
Solicitation Number: 36C24118Q9295
Contact: James PauletteSAO East Network Contracting Office 1 Togus VAMC 1 VA Center (90c)
Setaside: N/AN/A
Place of Performance (address): Manchester VAMC;
Place of Performance (zipcode): 03104
Place of Performance Country:
Description:
Togus VAMROC
This Sources Sought Notice is to assist the
B.5. PERFORMANCE BASED WORK STATEMENT
B.5.1 BACKGROUND:
1. The
B.5.2 SERVICES REQUIRED:
The hospital or
Contractor shall provide health services on a non-discriminatory basis to
For transports initiated by the contractor, the contractor shall be responsible for costs incurred for transporting patients between Contractor campuses or from Contractor facility to other health care sites for inpatient treatment when more appropriate care should be provided at the receiving facility. Under no circumstances will the veteran be charged for transportation costs. The
When transporting
Services to be provided to authorized
24 hour emergency /Observation/OBGYN/acute medical/surgical services
Provide inpatient hospital care in an acute care setting for the treatment of
Provide a network of specialty care providers , who are credentialed and privileged in the contracted hospital, to treat
Provide outpatient services of credentialed specialists for the treatment of
Diagnostic procedures
Pharmaceutical and therapeutic services
Inpatient mental health services (as appropriate)
Provide inpatient mental health care for the treatment of authorized
Provide a network of community mental health care providers, who are credentialed and privileged in the contracted facilities, to treat
Case Management, discharge planning and placement
When decision is made to transfer to HCO, the VAMC Urgent Care (UC) Staff will contact the HCO using agreed upon processes. Upon acceptance by HCO transfer of the patient will be arranged by the
Decision to accept patient is the responsibility of the HCO. Each
While patient is in the HCO acute care facility, patient progress will be communicated on a daily basis (HCO Case Manager to VA Case Manager Liaison and/or to VA Provider when appropriate, and HCO billing administrative services to VA Fee Basis). Transfers to Higher Level of Care (HLOC) require notification with the
Additional Requirements:
Contractor shall provide continuous care for authorized veterans and beneficiaries hospitalized at that facility until maximum hospital benefits are achieved or
The
Contractor shall receive pay for services performed under the agreement.
B.5.3 ORDERING PROCEDURES:
1. The ordering procedures listed below are to be used by both
2. Ordering Process:
If
Accepting medical facility accepts veteran
Transportation to accepting medical facility is arranged by
any radiographic needs are either sent via PAX or a copy is made to be sent with the veteran
Veteran arrives at accepting facility; physical transfer is completed
Report is called by VA Nursing Staff to accepting medical facility s Nursing Staff
Direct Admissions
Steps 1-8 above are followed, however if the patient is to be a direct admission the Nursing Supervisor of the accepting medical facility is called
Complaint requiring admission is relayed, the supervisor then has the Hospitalist to call the provider back for discussion and acceptance
Admitting department at the accepting medical facility calls
Return calls and bed assignments need to be accomplished in a timely fashion. No more than 30 mins between initial call and bed assignment
B.5.4 REPORTING REQUIREMENTS:
The provider or HCO Case Manager shall notify the VA Case Manager Liaison upon the following events:
Prior to discharge and for discharge follow up care recommendations
Upon death of the patient-provide date and time of death
When Home O2, IV infusion, DME,
Transferred to other contracted facilities, (i.e. skilled nursing, ICF, acute rehab, other
Multidisciplinary Patient and/or Family meetings, Palliative or Hospice Care Meetings
Significant changes in patient condition and/or when requiring a higher level of care.
A Daily census report shall be transmitted to the VA Case Management team office listing all Veteran inpatient admissions and discharges and designating whether the patient is on contract or fee and level of care status
Patient Medical Records
Requests for release of these records shall be referred to
When patient is discharged back to the
1. Copy of Discharge Summary
2. Copy of Patient Discharge Instructions
3. Copy of History and Physical
4. Copy of recent labs (all labs up to a maximum of two weeks)
5. Rehabilitation Services Discharge Summaries if applicable
6. Copy of Advance Directives (if changed)
7. Copies of all consults
8. Copies of Diagnostic Studies, biopsies and path results, etc.
9. Copy of Medication Administration Record
10. Copies of Imaging studies when appropriate
11. Appropriate transportation and/or facility transfer forms
Invoices for patient stays should be submitted within 7-10 days to:
The Contractor is authorized to retain the health care records for the time period that is specified by its own policies or by state law. The contractor will document on the cover sheet patient is currently receiving care at the HCO and information is needed as soon as possible.
Emergency medical information needed immediately for
(603) 624-4366 ext 6263 Administrative Officer of the Day (AOD) during WHEN hrs
(603) 624-4366 ext 6916 Release of information. FAX 603-626-6579
3. Clinical Information
Required clinical information includes but is not limited to the following:
Inpatient: Administration History and Physical, Discharge Summary, Operative Report (or Procedures Report), images where appropriate (digital whenever possible), treatment plan, completion summaries, medical device information, clinical notes, orders.
Outpatient: Completed consult, treatment plan, completion summaries, medical device information, and clinical notes.
Diagnostic Tests: Completed reading and results, completed consult and images where appropriate (digital whenever possible)
Contractors shall return all required complete clinical information to the
For all routine care completed clinical information and test results must be provided to the
For all inpatient care, complete clinical information must be provided to the
For all medical emergency care, complete clinical information must be provided to the authorizing agent or other
Evidence that each veteran patient medical record includes:
Appropriate patient identification to include name, sex, social security number, and date of birth
The patient medical history
Evidence of consent for care when consent is required by organizational policy
Documentation of care planning activities based on patient problems and needs
All appropriate diagnostic and therapeutic procedures, treatments, and tests and results
Reevaluation of patient in response to interventions
Patients vital signs including assessment of pain
Finding of initial assessment and reassessment(s)
The description of any safety measures required to protect the patient from injury
Description of the patients functional limitations related to care or services provided
Specific and appropriate notes on the care or service provided
Description of the patients activity restrictions, if any, as related to the care or services provided
Statement of any changes in patients condition related to the care or services provided
Documents of medication use and medication allergies or sensitivities
Legible & Complete physician orders as appropriate
Transfer forms, summaries, or copies of any record received from the transferring organization, documentations of patient and family education
Other individuals or organizations involved in patient care, referrals to internal and external care providers and community agencies, and dietary restrictions
4. Medical Claims Processing Requirements
Medical Claims (invoices) Processing Requirements
Medical claims, as used in the context of this agreement, are invoices prepared and submitted by the contractor that consist of the charges of the provider(s) for the health care services rendered to veterans as authorized by
Due to the current regulations, the
A Valid claim submission is processed in the Vista Fee System. For administrative purposes,
Valid Claim Submissions are:
HIPAA compliant EDI transaction sets (preferred method), or
Completed CMS 1450 (UB92/UB04) or CMS 1500 forms, depended type provided.
For VA Policy on submitting EDI claims see:
https://www.va.gov/COMMUNITYCARE/providers/info_payments.asp#process
For any paper claims, submissions the claim must contain completed standard billing CMS 1450 (UB92/UB04) or CMS 1500 forms, depending on the type of care provided.
Offerors are required to provide summary claims data including, but not limited to, number of claims submitted and total amount billing in the Monthly Report.
B.5.5 QUALITY ASSURANCE:
1. The contractor will be required to submit a quarterly quality report (Quarterly Quality Assurance/Care Coordination Report) which includes the following but is not limited to depending on the services:
Number of patients treated by Diagnostic Category
Inpatient Length of Stay
Nosocomial infection rates
Deaths
Procedures
Patient Concerns
Unresolved issues should be communicated at time of service
Adverse Events and Clinical Complications
Elopement/AMA discharges
Discharge / Placement locations
Falls
Restraint usage (medical and behavioral)
Catheter-associated urinary tract infections
Surgical site infections
2. Accreditation and Performance standards:
The
Contractor personnel shall be subject to the same quality assurance standards; meeting or exceeding current recognized national standards as all regular
The contractor shall provide a copy of documentation to support their accreditation. Any changes or challenges to accreditation status, during the period of performance must be immediately reported to the Contracting Officer.
All care required by this agreement shall be provided in accordance with the most recent Standards of the Contractor s Professional Accreditation.
Changes in accreditation status shall be communicated to the Contracting Officer, Contracting Officer s Representative (COR) and the
Certificates of Insurance coverage shall be sent to the Contracting Officer. Policy renewal statements, showing the agreement number, shall be sent to the Contracting Officer during the term of the agreement. The Contract Number shall be noted on this documentation. The Contract may be terminated for Default due to lack of insurance.
The contractor must be licensed in the state the contractor facility resides and Medicare approved. Laboratories must be inspected and approved by CAP or TJC for laboratory services. Radiological services must be performed in a radiology department that meets all State,
All providers rendering healthcare to
All licensed independent practitioners providing care to
The contractor must notify the Contracting Officer immediately of any changes in the licensure or status of hospital or HCO, any legal governmental action initiated against the contractor for professional negligence, violation of law, bankruptcy, lapse or material change in liability coverage, any other problem or situation that might impair the ability of the contractor to carry out its obligations under the agreement. The Contractor shall immediately notify
Link/URL: https://www.fbo.gov/spg/VA/ToVAMROC402/ToVAMROC402/36C24118Q9295/listing.html
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